P2Y12 inhibitors
P2Y12 inhibitors are antiplatelet drugs. They are are often used in combination with acetylsalicylic acid, which is called dual antiplatelet therapy (DAPT). However, they may also be used alone.
Compounds
- Clopidogrel (Plavix®)
- Prasugrel (Efient®)
- Ticagrelor (Brilique®)
Mechanism of action
These drugs inhibit the P2Y12 receptor, an ADP receptor which is found on platelets. This receptor binds ADP which is released from other activated platelets. By blocking the P2Y12 receptor these drugs prevent platelet aggregation.
Pharmacokinetics
Clopidogrel and prasugrel are irreversible inhibitors, while ticagrelor is a reversible inhibitor. They have similar half-lives but the effect lasts longer for the irreversible inhibitors, as new platelets must be formed for the effect to pass.
Monitoring
One can monitor P2Y12 therapeutic effect with platelet aggregometry with ADP, but this is not routinely performed. There are no known uses for this, as a therapeutic reference range has not been established.